Along this line, there are three things to consider as priorities.
These are; (A) airway (B) breathing and (C) circulation.
first, does your patient have a patent airway or is their airway obstructed due to obstruction caused by oral pharyngeal blockage (something in their mouth or throat) or is it blocked by an external restriction (IE hard forward chin position).
If your patient is not breathing, this is a life or limb scenario.
Reposition the head into a sniffing or straight line position and reassess breathing.
If the patient is now breathing, then the "A" is taken care of. If not, move into "B"
If the patient is not initially breathing, then reposition the Airway as discussed in "A".
If following "A", patient is still not breathing, initiate rescue breathing per American Red Cross or American Heart protocols but remember, if fluid movement is not occurring in the lung fields, then gas exchange is not occurring.
In other words, if blood isn't flowing through the lungs, then any gas you pump into the lungs isn't doing anybody any good.
Next is Circulation.
This is the component of the life saving process which is most vital if the other two factors have not fixed the problem.
With circulation comes a myriad of problems.
(1) is the pump (heart) functioning?
This is not an answered question, especially if EKG monitoring is not available.
I will write this section with the assumption that EKG is not available for patient diagnosis.
First, once patients airway has been established, then is the patient breathing on their own?
If not, the incorporate the use of a Bag Valve Mask (BVM), one which preferentially can be connected to supplemental oxygen. Once established, this is a "basic airway." If you, as the provider do not feel that this is adequate, then consider an Oral Pharyngeal Airway or a Nasopharyngeal airway.
I will not go into the use of these to VITAL life saving tools further because if you want to understand them then I strongly suggest you seek further training.
Suffice to say that NPA or OPA use is VERY IMPORTANT to airway management.
Finally, once airway and breathing/gas exchange are established, is the patient moving fluid (blood)?
If yes then your BVM and supplemental O2 should start having a positive effect (color changes to "pink") heart rate changes decreasing.
" These are things which indicate that there is enough fluid within the system and that the pump is working within accepted parameters. If the pump is not working right then you have other questions. Is there pump itself damaged or inadequate? Is the integrity of the tank intact (veins and arteries) Or three, is there simply not enough "
Article written by: mtnmedic1 28 Nov 2010 02:58 am
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